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Trial details imported from ClinicalTrials.gov
For full trial details, please see the original record at
https://clinicaltrials.gov/ct2/show/NCT01674608
Registration number
NCT01674608
Ethics application status
Date submitted
14/08/2012
Date registered
29/08/2012
Date last updated
6/05/2015
Titles & IDs
Public title
TEAM: Trial of Early Activity and Mobilization
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Scientific title
TEAM: An Multi-centre Observational Study of Early Activity and Mobilization in Australia and New Zealand
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Secondary ID [1]
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ICF
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Universal Trial Number (UTN)
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Trial acronym
TEAM
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Critically Ill Adults Ventilated >24 Hours in Intensive Care
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Condition category
Condition code
Intervention/exposure
Study type
Observational
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Patient registry
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
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Comparator / control treatment
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Control group
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Outcomes
Primary outcome [1]
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Best level of activity in ICU
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Assessment method [1]
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Highest level of activity (11 point scale) including:
unknown nothing (lying in bed, passive stretches) sitting in bed, active exercises in bed moved to chair (via hoist, slide etc but no standing) sitting over edge of bed standing transferring bed to chair marching on spot (at bedside) walking with assistance of 2 or more people walking with assistance of 1 person walking independently with a gait aid walking independently without a gait aid
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Timepoint [1]
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ICU stay (average 7 days)
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Primary outcome [2]
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Dosage of the best level of activity
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Assessment method [2]
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The time spent performing the best level of activity and the number of times it is achieved
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Timepoint [2]
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Intensive care unit stay (average 7 days)
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Primary outcome [3]
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Time to standing in ICU
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Assessment method [3]
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The number of days in ICU before a patient can stand
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Timepoint [3]
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Intensive care stay (average 7 days)
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Secondary outcome [1]
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Best level of activity at hospital discharge
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Assessment method [1]
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Highest level of activity (11 point scale) including:
unknown nothing (lying in bed, passive stretches) sitting in bed, active exercises in bed passively moved to chair (pat slide, hoist but no standing) sitting over edge of bed standing transferring bed to chair marching on spot (at bedside) walking with assistance of 2 or more people walking with assistance of 1 person walking independently with a gait aid walking independently without a gait aid
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Timepoint [1]
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Hospital stay (median days 14)
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Secondary outcome [2]
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Time to first sit out of bed
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Assessment method [2]
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The number of days until the patient can sit out of bed
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Timepoint [2]
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ICU stay (average 7 days)
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Secondary outcome [3]
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Barriers to mobilisation
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Assessment method [3]
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Factors that may have been a barrier to mobilizing patients in the ICU
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Timepoint [3]
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Intensive care unit stay (average 7 days)
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Secondary outcome [4]
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Mobilization related adverse events
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Assessment method [4]
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Adverse events that occured during patient mobilization such as an unplanned extubation or a fall to the floor
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Timepoint [4]
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Intensive care unit stay (average 7 days)
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Secondary outcome [5]
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Time to first physiotherapy
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Assessment method [5]
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The number of days in intensive care before the patient was reviewed by a physiotherapist
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Timepoint [5]
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Intensive care unit stay (average 7 days)
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Secondary outcome [6]
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Mechanical ventilation free days
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Assessment method [6]
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The number of mechanical ventilation free days to day 28
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Timepoint [6]
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28 days
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Secondary outcome [7]
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Intensive care unit free days
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Assessment method [7]
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The number of days the patient spent out of ICU to day 28 (if dead = 0)
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Timepoint [7]
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Day 28
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Secondary outcome [8]
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90 day mortality
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Assessment method [8]
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The mortality at day 90
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Timepoint [8]
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90 days
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Secondary outcome [9]
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Health related quality of life at 6 months
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Assessment method [9]
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Health related quality of life reported via telephone interview at 6 months using the EuroQoL EQ5D
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Timepoint [9]
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6 months
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Eligibility
Key inclusion criteria
- they have received invasive mechanical ventilation for at least 24 hours, and have
been in ICU less than 72 hours
- the treating clinician expects the patient to still be receiving invasive mechanical
ventilation in the ICU the day after tomorrow.
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Minimum age
18
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
- Age less than 18 years old
- Patient has a proven or suspected acute primary brain process that is likely to
result in global impairment of conscious level or cognition, such as traumatic
brain injury, intracranial haemorrhage, stroke, or hypoxic brain injury after
cardiac arrest or asphyxiation.
- Second or subsequent admission to ICU during a single hospital admission
- Patient does not speak English
- Patient has proven or suspected primary myopathic or neurological process
associated with prolonged weakness, such as Guillain-Barre syndrome
- Death is deemed imminent and inevitable
- Inability to walk without assistance prior to the acute illness that is
associated with admission to ICU (use of a cane or walker not an exclusion)
- Cognitive impairment prior to the acute illness that is associated with admission
to ICU (refer data dictionary)
- Any written "Rest In Bed" or non-weight bearing medical order such as may occur
with hip fracture, unstable spine or pelvis, pathological fracture
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Study design
Purpose
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Duration
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Selection
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Timing
Prospective
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Statistical methods / analysis
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Recruitment
Recruitment status
Completed
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Data analysis
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Reason for early stopping/withdrawal
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Other reasons
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Date of first participant enrolment
Anticipated
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Actual
1/07/2012
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
1/03/2014
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Sample size
Target
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Accrual to date
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Final
192
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Alfred - Melbourne
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Recruitment postcode(s) [1]
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3104 - Melbourne
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Wellington
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Funding & Sponsors
Primary sponsor type
Other
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Name
Australian and New Zealand Intensive Care Research Centre
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Address
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Country
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Other collaborator category [1]
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Other
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Name [1]
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Intensive Care Foundation, Australia
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Address [1]
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Country [1]
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Ethics approval
Ethics application status
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Summary
Brief summary
Patients in the Intensive Care Unit (ICU) traditionally receive bed rest as part of their
care. They develop muscle weakness even after only a few days of mechanical ventilation that
may prolong their time in ICU and in hospital, but the nature of such weakness is poorly
understood.
The weakness that develops in ICU is more substantial than that which would result from bed
rest alone and is referred to as ICU acquired weakness (ICUAW). This weakness might be due to
the combination of inflammation and immobility. The exact mechanisms leading to the nerve and
muscle damage which occurs in critical illness are not yet fully understood and require
further investigation. However, it is known that ICUAW has an effect on a patient's ability
to breathe without a ventilator, walk and perform simple activities (like washing and
toileting) and often results in longer mechanical ventilation time and hence, longer hospital
stays than might otherwise be expected. It may also affect a patient's ability to return home
after their hospital stay. The recovery period in Australian and New Zealand ICU patients is
unknown but a trial from Canada has reported ongoing weakness five years after leaving ICU.
Weakness in survivors of intensive care is known to be a substantial problem. It is currently
not known whether ICUAW may be avoided or its severity reduced with simple strategies of
early exercise in ICU.
There are no data about the level of activity and mobility in critically ill patients in
Australian and New Zealand ICUs. These data are urgently required to plan a program of
research to test whether increasing the level of mobility and activity in our critically ill
patients is safe, feasible and efficacious in terms of reducing the severity of ICUAW and
improving patient-centred outcomes. The program of research will first include a study to
observe the mobility levels in 25 ICUs across Australia and New Zealand to determine safety,
barriers to mobility and what type of activities are undertaken by our patients.
From the observational data we plan to develop a pilot randomised controlled trial of early
mobility and activity in intensive care units across Australia and New Zealand. This simple,
cost-effective strategy may improve functional ability, decrease time on mechanical
ventilation and improve long term outcomes in this patient group. By initiating such a
program, ANZ investigators might be able to change future patient outcomes worldwide.
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Trial website
https://clinicaltrials.gov/ct2/show/NCT01674608
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Carol Hodgson, PhD
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Address
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ANZIC-RC
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Country
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Phone
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Fax
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Email
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Contact person for public queries
Name
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Address
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Country
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Phone
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Fax
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Email
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Contact person for scientific queries
Summary Results
For IPD and results data, please see
https://clinicaltrials.gov/ct2/show/NCT01674608
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